Physical Therapy Protocols Edited by Janet Bezner

Ankle Fracture Protocol Objectives I. Achieve functional range of motion. II. Achieve functional strength. III. Establish independent gait. IV. Return patient to previous functional activities. Admission/Evaluation 1. Areas to evaluate A. Postoperative inpat!.ent 1. Range of motion a. Involved ankle is usually in short leg cast. b. Specifically assess knee and hip range of motion of involved lower extremity and gross range of motion of other extremities. 2. Muscle strength. Grossly assess strength of all extremities. 3. Neurological. Assess sensation of area distal to cast on involved extremity. 4. Functional ability. Assess ability to transfer from a sitting to a standing position. 5. Gait. Evaluate use of assistive device, distance ambulated, and amount of assistance required. (Patient is usually non-weight bearing.) 6. Cardiorespiratory. Evaluate pre-existing conditions; note heart rate and blood pressure response during gait. B. Outpatient 1. Range of motion a. Same as above until cast has been removed at six to eight weeks, when fracture has healed. b. Measure specific ankle and toe motion when cast is removed. 2. Muscle strength a. Same as above until cast has been removed. b. Measure specific ankle and toe strength when cast has been removed and adequate healing has occurred. 3. Neurological. Assess involved foot and ankle when cast is removed. 4. Functional ability. Assess transfers in home and community. 5. Gait. Assess weight-bearing status and assistive device requirements as patient progresses from non-weight bearing to independent. II. Precautions during treatment: None Copyright © 1991 by Therapy Skill Builders, a division of The Psychological Corporation/ All rights reserved / 1-ID}-228{)752/ ISBN 07616681280 75